Week 1: Beginning Summer Immersion and Shadowing in Cardiology

 

My name is Cole and I work in Dr. Yadong Wang’s group at Cornell. My research focuses on synthesis of materials for use in degradable electrowritten vascular grafts. During my first year I also worked on a side project to support a grant Dr. Wang was preparing with Dr. Johnathan Weinsaft, a Cardiologist at Weill Cornell. Through this association Dr. Weinsaft was recommended to be my clinical mentor.  

On my first day of Immersion I met with Dr. Weinsaft and his MRI focused group. He introduced me to his fellows, provided me with a review article on Cardiac MRI, and invited me to participate in that evenings MRI case readings. The readings were particularly enriching as I learned how different techniques are employed during imaging to obtain relevant information, some of which I was unaware could be acquired by the modality. For instance, I learned that MRI can distinguish dead from hibernating cardiomyocytes using gadolinium (a contrast agent) infiltration and persistence in dead tissue. Observing Dr. Weinsaft and his fellows interpret the data was very fascinating.

I continued learning about cardiac MRI from the fellows the next day and received one-on-one time with the senior fellow who walked me through the process of analyzing the images. I am very excited to use MRI in my summer project!

On Wednesday I shadowed fellows within Nuclear Cardiology. I witnessed patient interactions, observed the collection of SPECT images following stress tests, and learned how these images are understood. The fellows I worked with were both extremely helpful in teaching me to understand the data and what markers of abnormalities to look for. I was really interesting seeing the patients before their stress test knowing that some of these people may need technology like that I am working on.

The following day I was brought to Electrophysiology where I observed two procedures. In both cases, four catheter studies were performed to learn about the electrical activity of the heart. The first procedure treated atrial fibrillations by electrically isolating the veins, which are believed to the source of the fibrillations, via ablation. The second procedure treated supraventricular tachycardia by first locating the source of the rapid pacing, and then ablating it until the tachycardia was no longer inducible. Both of these procedures utilized a small team of biomedical engineers controlling the computer software that guided the surgeon.

On Friday I continued shadowing in the EP labs and watched two pacemaker implantations. The first was a traditional pacemaker implanted below the subcutaneous fat, with two leads wires that extend into the chambers of the heart. The second was a new leadless pacemaker pair that was inserted directly into the heart chambers. One thing I found interesting about both pacemaker is that they have a finite battery life of ~10-15 years, and after the battery begins to fail another procedure is needed to replace the entire device. It seems to me that the longevity of these pacemakers, along with patient quality of life could be improved by introducing inductive charging. Although this may require more frequent recharging and may exclude MRI, it may be a better option than intermittent surgery, especially for the older population.         

Altogether, I had a great first week and I am excited to learn more.